切开复位重建钢板内固定治疗移位Miller-AdaⅡ、Ⅲ型肩胛骨骨折

The treatment of displaced Miller-Ada Ⅱ and Ⅲ type scapular fracture using open reduction and internal fixation with reconstructive plates

目的探讨切开复位重建钢板内固定治疗移位Miller-AdaⅡ、Ⅲ型肩胛骨骨折疗效。方法采用切开复位重建钢板内固定治疗23例移位Miller-AdaⅡ、Ⅲ型肩胛骨骨折,记录术后近期并发症、骨折愈合时间和肩关节外展功能。结果所有患者术后无切口感染。17例患者得到随访,时间4～24个月,骨折均愈合,愈合时间12～24周。肩关节外展90°～170°,平均150°。根据Neer肩关节功能评定标准:优13例,满意2例,不满意2例。结论采用切开复位重建钢板内固定治疗移位Miller-AdaⅡ、Ⅲ型肩胛骨骨折可获得良好的临床效果。

Objectives To assess the methods and results of surgical treatment of scapular fractures classified as Miller-Aria type Ⅱ and Ⅲ. Methods 23 case of scapular fractures classified as Miller-Aria typeⅡand Ⅲ were treated with open reduction and internal fixation with contoured reconstructive plate. The postoperative complications, the bone healing times and the abductions of the shoulders were recorded. Results All the patients underwent smoothly wound healing process without infections or dehiscences. The results of 17 patients were evaluated at the follow-up ranged from 4 to 27 months. All 17 fractures united uneventfully within a bone healing time ranged from 12 to 24 weeks. The average shoulder abduction was 130 degrees （range 90 -170 degrees）. According to the Neer＇s scoring system, 13 patients had excellent results, 2 satisfied, and another had 2 unsatisfied results. Conclusions Good clinical outcomes could be obtained when open reduction and internal fixation with reconstructive plates were selected to treat the displaced Miller-Aria Ⅱ and Ⅲscapular fractures.